<!DOCTYPE html>
<html>
<head lang="en">
    <meta charset="UTF-8">
    <meta name="viewport"
          content="width=device-width, user-scalable=no, initial-scale=1.0, maximum-scale=1.0, minimum-scale=1.0">
    <title></title>
    <link rel="stylesheet" href="../css/common.css"/>
    <link rel="stylesheet" href="../css/add_people.css"/>
    <script src="http://cdn.static.runoob.com/libs/jquery/1.10.2/jquery.min.js"></script>
    <script src="../js/jquery.cookie.js"></script>
    <script src="../js/config.js"></script>
    <script src="../js/addPersonReference.js"></script>
</head>
<body>
<div id="header">
    <p>添加就诊人</p>
    <span class="back"><a href="javascript:window.history.go(-1);">返回</a></span>
</div>
<div id="main">
    <form action="">
        <ul>
            <li><span>姓名</span>

                <p><input type="text" class="user-name"/></p></li>
            <li><span>性别</span>

                <p><input type="text" class="user-gender"/></p></li>
            <li><span>出生日期</span>

                <p><input type="date" class="user-birthday"/></p></li>
            <li><span>成员关系</span>

                <p><input type="text" value="" placeholder="必填" class="user-relation"/></p></li>
            <li><span>身份证号</span>

                <p><input type="text" value="" placeholder="必填" class="user-idcard"/></p></li>
            <li><span>联系方式</span>

                <p><input type="tel" value="" class="user-tel"/></p></li>
            <li><span>验证码</span> <input type="text" placeholder="请输入验证码"/><i>点击获取</i></li>
        </ul>
        <input class="save" type="button" value="保存"/>
    </form>
</div>
</body>
</html>